I was wondering what referring doctor NPI other radiology practices are submitting to insurances when patients are having mammograms that are self referred. Are you using the group NPI as the referring (since the billing system will not release claims if this area is blank)? Thank you for any input!
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Tag Archives: referring
Referring Physician Question
Can someone please tell me who is used as the referring physician on a claim if the patient was not referred to the podiatrist by a physician? Use the podiatrist as rendering and referring?
Ordering Referring
Can someone tell me which Types of bills for Part A require an ordering/referring physician on the UB for diagnostic test or DME supplies ordered
NPs referring patients to physicians
Circumstances:
– Nurse Practitioner sees patient at a Facility Based clinic for Breast Health (for high risk or benign patients)
– After exam, she determines patient needs a surgical intervention
– She bills new patient visit independently
– She refers the patient that requires surgical intervention to a surgeon employed by the same group under the same TIN.
– Nurse Practitioner has a different Taxonomy code (for specialty and sub specialty) than the surgeon
– Nurse Practitioner sees patient at a Facility Based clinic for Breast Health (for high risk or benign patients)
– After exam, she determines patient needs a surgical intervention
– She bills new patient visit independently
– She refers the patient that requires surgical intervention to a surgeon employed by the same group under the same TIN.
– Nurse Practitioner has a different Taxonomy code (for specialty and sub specialty) than the surgeon
In this circumstance, can the surgeon bill this visit as a new patient visit as well? Does this constitute a compliance issue or anti Stark issue? Especially if the same NP is assisting the surgeon with dictations and exam on her non practice days?